Primary aortojejunal fistula due to foreign body: a rare cause of gastrointestinal bleeding

Primary and secondary aortoenteric fistulae are infrequent causes of gastrointestinal bleeding. We report a rare case of a 49-year-old man with bleeding due to an aortojejunal fistula caused by a foreign body. This is the fifth case in the literature in which a foreign body was found to be associated with the development of an aortoenteric fistula. Our patient presented with two herald bleeds with an interval time of 1 week; in previous cases, only one herald bleed has been reported. In addition to the usual resuscitation measures, the patient was treated with primary repair of the small-intestine defect and replacement of the aneurysm with a prosthetic aortic graft. He remains in excellent health thereafter.